Beyond Telemedicine: UK doctors ‘train the trainer’ in India to fight Covid-19

Shefali Saxena Tuesday 04th May 2021 05:57 EDT
 

Over 60,000 doctors of Indian origin working in the NHS are going online to provide remote consultations in local languages and support overwhelmed colleagues, many of whom are falling ill themselves, The Times has reported. While telemedicine has come across as a boon to India from the UK, many doctors in Britain are helping India fight the second wave of coronavirus. 

Dr Ashish Dhawan, Consultant Cardiologist and General Secretary - British International Doctors Association and his team have gone beyond just telemedicine to help India fight the second wave of Covid-19. 

In our primary research, we found that many doctors in India are territorial about treating patients within a particular state and refuse to give consultation to someone residing in another state because they feel that the strain of the virus is different in different regions and hence affects people differently. 

Commenting on this, Dr Dhawan told Asian Voice, “I’m in Manchester which is 400 or 500 Km away from London, and Glasgow is about 1000 kms away from London. No doctor in Glasgow will say that I can’t treat a patient in London. If you tell a British doctor this concept, they will not buy it. I’m not criticising Indian doctors, but it is a virus. Because our microbiology skills are so advanced, we are able to study the virus strains down to the minutest level. Because it is a virus, treatment options are very limited.”

It is also widely known that India has developed a black market for Covid medicines like Remdesivir and basic Oxygen cylinders in the last one month due to panic buying and self medication. An injection worth £20 is being sold for £250-£500 to desperate patients. 

Dr Dhawan said, “We know Indian doctors are doing everything they can do in their capacity, but there’s not much evidence that Remdesivir helps in treating Covid. If you speak to ten doctors in the UK, five will give it, five won’t.”

“Everyone should get basic treatment, everyone should get steroids which is very very cheap (inexpensive) and after that you just have to wait for your immune system to kick in and give it support. We don’t use Flubijab which is being used in India; we use Remdesivir, antibiotics and steroids,” he added. 

 A medical volunteers organisation from Pune (Puna Feed The Need) approached BIDA. Some of these people are pharmacists, some are non-medicos, some are biochemists, some are medical students and volunteers. Dr Dhawan said that they can easily handle the call and tell patients what to do. He said, “We organised a webinar with them.  They had good questions for us. We explained the role of certain medicines to them and we are training the medical workforce of India. If we train these people who are partially trained RMPs, homeopaths, they can handle even basic treatment.”

Dr Dhawan thinks that sharing British expertise with Indian medical fraternity will help them in reading the situation for patients and giving them basic medical assistance. 

He further added, “We’re happy to train people. For example they want to know when they should be worried about SPO2 levels, we can help them in understanding when to put a patient on oxygen. You could probably call it a modified form of telemedicine.”

“In Britain, we can observe and tell when a Covid patient walks in whether they would make it or not.  We’ve not had good results at all when we’ve put people on Ventilator. In the UK, the healthcare system is nationalised, but in India, a patient will walk in and say I’ve got money, I can pay for an ICU,” he said as he discussed that India needs national guidelines that should be applied to every hospital. “Otherwise India will lose a lot of people,” he added. 

Dr Dhawan also told Asian Voice that he and his organisation are raising money through British doctors and the public. “We’ve got follow up calls with the Indian medical volunteers organisation,” he said while he reasoned out one ongoing practice in India of massively using plasma therapy, “British experts also say that there is no role of plasma in Covid treatment. You can’t put 20 million people on ventilators. We’re focusing on smaller cities and towns. As and when people approach us how to drive patients, we’ll help them in doing that.”

Dr Chandra Kanneganti (Principal GP, Goldenhill &  Middleport, Director, GMS Ltd and LMC secretary, North Staffs LMC) told Asian Voice, “Other measures we are currently  delivering are healthcare through telemedicine and home support for Covid positive with mild symptoms. Rather than inventing our own platform, we have requested our BIDA members to be volunteers to provide telemedicine and gave info of all the current links for that. We have a number of BIDA members working as volunteers already. Some of us are also providing advice to our friends and relatives in India by online video platforms. The huge experience of UK GP’s working through remote ways of working since last year is helping.”

         

 

Speaking to Asian Voice, Dr Preeti Shukla, GP Partner and GP chair, BIDA said, “We are using the approach of ‘train the trainer’. We are sharing our knowledge and experience gained during Covid second wave in England with doctors and allied health professionals in India such as home management and home pulse oximetry model and strong public health messaging . Recently BIDA organised our first meeting with colleagues in Pune and we plan to expand on it.” 

 

Sai Pillarisetti, President BIDA Student Wing told Asian Voice that, “I feel proud to be a part of BIDA where we are effectively utilising our platform to provide Covid related medical advice to Indian medical volunteers via video conference as well as shortly commencing tele-medicine services. The BIDA Student Wing is actively supporting this cause by promoting the BIDA fundraiser on JustGiving.com which is collecting money to support India with oxygen supplies. We have raised over £40,000 in less than a week and we hope to keep this momentum going so we can help as many people as possible.”

 

BAPIO has three prompt strategies to help India. Speaking to Asian Voice, Dr Ramesh Mehta said that BAPIO is providing support  for oxygenation. “We have set up an e-medicine platform for supporting our colleagues in India who are doing an excellent job but are tired and exhausted. So we will be extending clinical decision making advice to doctors in small towns in remote areas of India. We are collaborating with a charity called Akshaya patra to provide ration and meals to daily wage earners who are out of jobs. The bags from England will contain ration for a family of four for a month. For all these activities we are raising funds and we are getting excellent responses from colleagues and the rest of the population.”


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